Jess Weiner: "Did Loving My Body Almost Kill Me?"

At a packed South Florida Barnes & Noble several years ago, I was speaking to a hometown crowd of my family, friends and fans for the release of my second book, Life Doesn't Begin 5 Pounds From Now. I gave a speech I'd given before, telling the audience that it was important for every woman of every size to love her body, no matter what. And that's when a woman in the front row raised her hand and changed my life forever.

"How can you honestly tell us that you love your body?" she asked. "You are obese."

My face flushed at her rudeness. I was shocked and embarrassed, but responded firmly: "My body is none of your business." The audience erupted into cheers.

But the woman continued. "What about health?" she asked me. "How can you be healthy looking like that?"

Again I had an answer ready. "You can't tell someone's health just by looking at them," I told her. "So don't assume that just because someone is overweight that he or she is unhealthy." And again the crowd cheered, and that was that. Friends asked the woman to leave, and I finished up my talk, forcing a phony smile.

It wasn't the first time I'd been confronted about my work and my self-love messages. But that night I felt as though I had been exposed. The woman's caustic question nagged at me: How healthy was I? My weight hadn't stood in the way of my dating gorgeous men or succeeding in my career. But I couldn't remember the last time I'd been to the doctor. And it had been 16 years since I weighed myself. In fact, I'd stopped completely when I began recovery from the eating disorder I'd suffered in my teens. So I didn't know: Was I really obese? My body wasn't anyone else's business, but had I done everything I could to make it my business?

I realized I had to be honest with myself. I had to answer that woman's question—not for her, but for me. I picked up the phone and made a doctor's appointment.

My Big Decision

I'm not the only woman with weight issues to shun medical checkups—and the issue of health in general. Like me, many women recovering from eating disorders step away from the scale to focus on their value independent of numbers. And "some heavier women avoid the doctor completely for fear they'll be shamed about their body," says Cynthia Bulik, Ph.D., director of the University of North Carolina Eating Disorders Program. Their worries may be legitimate: Studies have found that many doctors have less respect for their overweight patients than for thinner ones, and some experts say that medical professionals have a history of recommending weight loss as a cure-all. "Sometimes it's hard for physicians to see past a woman's weight," says Bulik. "No matter what problem she brings into the office, their immediate response is Well, the first thing you need to do is take off some weight.' This simplistic thinking is hurting women's health."

That kind of bias, along with the finger-wagging from our thinness-obsessed culture, has helped fuel what's become known as the body-acceptance movement. "If society is saying, Shame on you. You're lazy. You're not trying,' we can expect a defensive reaction among women: Shame on you—I'm heavy, and I'm proud,'" says David L. Katz, M.D., M.P.H., an obesity specialist and director of the Yale University Prevention Research Center.

I'd been a proud leader and a strong voice within that movement. I'd written books and magazine columns, appeared countless times on Oprah and other TV shows, and given hundreds of speeches telling women to love themselves no matter what their size. But now it was time to consider not just my self-esteem but also my well-being. After all, says Dr. Katz, "Women should be able to feel confident in their body image. But there's a danger in the OK at any size' message. The fact is that obesity is a risk factor for heart disease, for cancer, for diabetes. It's not OK to say OK at any size' if your size has implications for your health."

I felt I'd be in good hands with Nadini Verma, M.D., the ob-gyn I also considered my primary care doctor. I loved her no-nonsense attitude and warm demeanor, and I knew she'd give me a fair assessment. After she ran a few tests, she sat me down.

"Jess," she said, "your blood sugar numbers show me that you are almost in the prediabetic range. If you don't lose some weight and watch your sugar intake, you will get diabetes." It was a harsh truth: Diabetes is a disease you can't easily undo. And then she showed me these stats—stats I never thought I'd share with anyone:

250: My weight at the time

99: My blood sugar—anything between 100 and 125 is prediabetic

146: My LDL, or "bad," cholesterol—borderline high

40: My HDL, or "good," cholesterol—that number should be 50 or higher for women

150: My triglycerides—borderline high

120/72: My blood pressure—the only figure in a healthy range

Dr. Verma had no pity or shame in her voice as she shared these findings with me. These were just numbers, after all. But these numbers told me that I wasn't just overweight—I was unhealthily overweight. I wasn't processing insulin properly. My arteries were quickly clogging. And I was in danger of becoming irreversibly sick.

It didn't matter in that moment, sitting half dressed in a paper gown, how many books I had written or speeches I had given about loving your body and accepting yourself as you are. The cold, hard truth was that accepting myself as I was was putting my life in danger. But could I really call a public time-out and say, "I'm going to focus on losing some weight now"?

I was about to find out.

Prepping for the Backlash

I knew dropping pounds or even talking about a diet could be career suicide for me. When Oprah slimmed down, some of her fans got angry; and after plus-size model Crystal Renn lost weight, some comments were vicious. One skeptic lashed out: "She's a hypocrite, and her whole pseudo plight for plus-size models was a publicity stunt." It's like when celebs get a nose job and say it was because they had a deviated septum—you never believe them. Instead, you think, Now there's one fewer of us who's succeeding "as is," one more woman who caved to the image machine that wants us all to be skinnier, prettier, more "perfect."

When I confided to a colleague about my plans, she suspected that that exact pressure was getting to me. "Are you sure you want to do this?" she asked.

I wasn't sure. I didn't want to join the ranks of women who felt as though weight loss alone made them "healthier." But when I thought about how I felt physically—weighted down and not as strong and vibrant as I would like—the realization hit me like a ton of bricks: I needed to go deeper than the mantras and speeches. To truly love my body, I had to treat it better.

I started doing just that. With Dr. Verma's guidance, I sought out a nutritionist, who helped me understand how my body breaks down insulin and who tasked me with choosing foods that have at most 10 ingredients and 5 grams of sugar per serving. (I've come to appreciate fresh veggies and whole-grain wraps.) It was a blow to realize how many foods I liked had unhealthy chemicals and extra sugar in them—such as many cereals and yogurts—but she taught me to feed my body five times a day to keep my blood sugar steady. And slowly but surely, things got easier.

Knowing that I enjoy working out in a group, I joined a gym that offered dance and water-aerobics classes. I was one of the bigger women there (I do live in Los Angeles), but I powered through my negative inner voice and kept myself committed. I also started seeing a therapist to work on the emotional baggage I carry and how it plays a part in the way I turn to food for solace, not nutrition.

During those first months, it felt like a fog was lifting. I felt stronger, more in tune with my body. And after 18 months, how were my numbers?

225: My weight

88: My blood sugar—normal!

116: My LDL—out of danger

50: My HDL—up 10 points

129: My triglycerides—no longer a risk factor

110/80: My blood pressure—superhealthy

Dr. Verma stared at me: "These numbers are fantastic! You are out of the prediabetes zone, and you've dropped your cholesterol." But I was a little pissed off. "I've only lost 25 pounds?" I asked. I thought declining desserts and exercising when exhausted would have brought me a more dramatic verdict. "Jess, you're focusing on the wrong number," Dr. Verma said. "Health is more than just your weight."

Health is more than just your weight; of course she's right. A recent University of Medicine and Dentistry of New Jersey study found that nearly 30 percent of obese patients had healthy blood pressure, cholesterol and other numbers. Still, personally, I never would have gotten my healthier numbers without confronting my weight. I know I'll never be skinny, and I'm fine with that, but I'm still focused on losing more weight—30 more pounds is my goal—so I can stay out of the diabetes danger zone.

What about all my fans and readers? I had been so worried about their reaction to my new healthy-weight message. Indeed, when I first talked about it in a keynote speech at a Binge Eating Disorder Association convention in Scottsdale, Arizona, this past spring, a woman approached me afterward. "So now you're saying that my life will begin when I lose weight?" she chided. But I didn't feel the same hurt and embarrassment as that night so long ago in the bookstore. "Not at all," I said. "There is no shame in carrying extra weight, but there's also no shame in wanting to be healthy. The more we support one another in that thinking, the better off we'll be."

And guess what? Women were more supportive than I'd ever expected, and many of them even admitted that they too wanted to lose weight to improve their health but had, like me, felt trapped by the stigma that confident, heavy women weren't supposed to think about weight at all. Like me, they felt liberated by the idea that it wouldn't betray their ideals to value their physical health.

I understand why women are so fed up with being told by society (and doctors) that they need to get to some "ideal" size. I get why they'd want to rebel and no longer care about weight—I've been there too. But we also can't pretend illness doesn't happen to us. Health matters, and paying attention to markers like your cholesterol, blood pressure and, yes, your weight doesn't mean you're giving in to some societal ideal. It means that you're listening to your body on the inside, which is a crucial part of loving yourself completely.

Jess Weiner is an author, self-esteem expert and public speaker. She's at jessweiner.com.